Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health

Introduction: Toxic mushroom exposures can occur through multiple mechanisms, including consumption as a delicacy, foraging, and use for psychoactive properties. Recent evidence suggests that psylocibin mushroom use is increasing in the United States. However, information on trends in mushroom poisonings in Florida is limited. This study aims to characterize trends in psychoactive and nonpsychoactive mushroom exposures reported to the Florida Poison Information Center Network (FPICN) over an 11-year period.

Methods: This is a retrospective review of all mushroom exposures reported to the FPICN between 2014 to 2024. Our primary outcome was to evaluate the annual trend of psychoactive and nonpsychoactive exposures. Secondary outcomes included identifying patient demographics, exposure intent, clinical effects, and medical outcomes associated with each exposure type. Psychoactive mushrooms were defined as belonging to groups 2 (muscimol), 4 (muscarine and histamine), and 6 (psilocybin and psilocin) in the National Poison Data System coding manual. We performed statistical analyses using chi-square and Mann–Whitney tests, and joinpoint regression models.

Results: A total of 2,995 mushroom exposures were reported. Psychoactive mushrooms comprised 15.6% (n = 467) of exposures and were more likely to involve males (72.5%, P < .001) and intentional ingestions (80.9%, P < .001). Joinpoint regression analysis showed that from 2014 to 2018, the rate of psychoactive mushroom exposures did not change significantly (annual percentage change [APC] = −1.5%; 95% CI, −35.9% to 19.3%; P = .88). In contrast, from 2018 through 2024, exposure rates increased significantly by an average of 34.4% per year (APC = 34.4%; 95% CI, 27.0%–60.4%, P < .001). These trends were standardized to overall poison center call volume. There were three deaths: a 67-year-old male (intentional–suspected suicide); an 81-year-old male (unintentional); and a 44-year-old female (unintentional), all involving mushrooms of unknown category.

Conclusion: Psychoactive mushroom exposures in Florida have increased substantially since 2018, particularly among adolescents and adults, and were more commonly associated with intentional use. These findings may reflect changing cultural attitudes and increased accessibility. Further research is needed to better understand the evolving landscape associated with psychoactive mushroom use.